| NPI | 1699024562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9106682) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106682) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2025-01-02 |